Epidural thickness of the dura sealants HEMOPATCH® and TACHOSIL® after elective supratentorial craniotomy: A comparative retrospective monocentric cohort study

This study compares the in vivo behavior (epidural thickness and complication rate including the development of cerebrospinal fluid fistula, CSF-fistula) of the newer dura sealant HEMOPATCH® (HP) with that of the well-established patch TACHOSIL® (TS) in early postoperative magnetic resonance imaging (MRI) and during the clinical course after supratentorial cranial surgery. This retrospective cohort study included 58 patients with complete datasets (HP group n = 39, TS group n = 19). Inclusion criteria were supratentorial surgery, use of one dura sealant (HP or TS), re-implantation of the bone flap, and MRI within 3 months after surgery. We measured the thickness of the used dura sealant in axial T1-weighted sequences of postoperative MRI on the area of suture (central) and on two peripheral spots. Additionally, we examined the incidence of surgical revisions due to hemorrhage, infection, and wound healing disorders. The mean central thickness of HP and TS were 0.49 cm and 0.55 cm, respectively. This difference in size was not statistically significant ( p = 0.066). The peripheral epidural thickness of HP (d = 0.36 cm) was significantly smaller than of TS (d = 0.42 cm; p = 0.014) in one of two points of peripheral measurement. Similarly, the two groups did not differ significantly in the complication rate needing surgical revision, including CSF fistula (HP 3/39 vs TS 3/19; p = 0.34). The biological behavior in terms of growth, swelling, induction of wound healing disorders, hemorrhage, and development of CSF-fistula showed no statistically significant difference within this small descriptive cohort.